So I’m reading comments on my Doctor Delicious post and I see a comment from a reader named Yoyo. Interesting really. Yoyo doesn’t understand why anyone would want a Delicious page for patient information and resources. She just wants to be cared for without knowing every detail.
It got me thinking: Is there a role for paternalism in the provider-patient relationship? Is there ever a time when someone should just be cared for without having to double and triple check his doctor?
Perhaps. I remember when my wife and I went through fertility treatment. We did our homework up front, triple checked our network of contacts, chose a doctor, made an initial appointment (‘interview’) and then decided that this was our doc. At this point we put ourselves in her hands. Part confidence part faith. Never a Google search. And then we had a baby. I might even suggest that in our case a hands-off approach was instrumental in conception.
But everyone’s different, of course. A heavy-handed role offers a sense of control that some patients want in a relationship with a doctor. And there are many situations where medical management isn’t as clear-cut as uncomplicated in vitro ferilization. In many cases medical vigilance is key to survival.
But while deep patient involvement is becoming the norm, there may be a time and place for someone smart and trusted to just show us what to do.
{ 6 comments… read them below or add one }
Great Post!
While it's really important for patients to be proactive and in charge of their health there are some patients who simply don't want to know every detail. They put their trust in doctors and nurses to provide the best possible care.
Interesting Post…as a physician with access to information online, when it comes to myself or my family, I always do the research on finding the right doctor. But once the connection is made, I stay away from the web and put my trust in the one I have chosen to guide me. I don't mind when my patients question my approach with news stories or online articles, but it's something I rarely do myself as a patient.
What we all need is a giant step back and a huge leap of faith. Our current system fosters second guessing and that's not healthy. As a result, too many patients over google and have trouble trusting. With the right doctor, not googling and just trusting is the most healing path you can be on. I learned that many times over on my journey to getting my back healthy and it's opened my eyes enormously to how online information can be a blessing and a curse. In the end, it's about moderation. And, in an ideal world the online information would be used as a bridge back to the physician and not in place of the physician.
Hi, thanks for the follow up. I should clarify that while i first started treatment I would probably have liked to just trust the doctor to rx what was needed, at this point I would prefer to talk about the latest clinical study or alpha2 receptor afinity etc. I do think looking behind the curtain results in the loss of something like the placebo effect. And trust in a doctor might also help a patient accept a change that feels difficult. Also, there really isn't a clear line of what is medical versus lifestyle, in drawing a line between drug/vitamin/meditation/sleep habit/diet etc. (probably even more so with paediatrics). I think patients might also suggest things a doctor sort of ignores because the doctor doesn't like the risk/payoff of some treatment, even though the patient might prefer it. A doctor's web presence might also be quite helpful to a patient looking for a new doctor: it gives a sense both doctor's approach and personality, as well as areas of interest.
Okay, but you have a "network of contacts" to triple check and presumably that network includes other medical professionals, and I'm guessing you have unfettered access to a medical journal or two. Most of us regular folks don't have these resources and are left with Google.
As for IVF being "clear-cut," well, we clearly had very different journeys through the land of assisted reproduction.
BG, yes we did our homework looking for a good fertility person but the point was that despite my access to journals, I never looked. That was the point. It was if I didn't want to know. I wanted to turn that over to someone else. And as a pediatrician I really am so far removed from from reproductive endocrinology that I knew effectively nothing about our injections. I went on nothing other than the support offered by the office we used.
Absolutely fertility is complicated and many couples don't conceive with a couple of rounds of IVF. Certainly in these cases a couple may need to take a more proactive role. Hope I didn't offend you in any way!